First cross-border outbreak of foodborne botulism in the European Union associated with the consumption of commercial dried roach ( Rutilus rutilus )

• Published in: Frontiers in public health 2023-01, Vol.10, p.1039770
• Main Authors: Hendrickx, David, Varela Martínez, Carmen, Contzen, Matthias, Wagner-Wiening, Christiane, Janke, Karl-Heinz, Hernando Jiménez, Pablo, Massing, Susanne, Pichler, Jeanette, Tichaczek-Dischinger, Petra, Burckhardt, Florian, Stark, Klaus, Katz, Katharina, Jurke, Annette, Thole, Sebastian, Carbó, Rosa, Del Pobil Ferré, Mariam Pascual, Nieto, Milagros, Zamora, María Jesús, Sisó, Ana, Pallares García, Pilar, Valdezate, Sylvia, Schaade, Lars, Worbs, Sylvia, Dorner, Brigitte Gertrud, Frank, Christina, Dorner, Martin Bernhard
• Format: Article
• Language: English
• Subjects: Animals; Botulism - diagnosis; Botulism - epidemiology; Clostridium botulinum; Clostridium botulinum type E; commercial dried roach; Cyprinidae; Disease Outbreaks; European Union; fish; foodborne botulism; Humans; outbreak investigation; Public Health; Rutilus rutilus; Sodium Chloride, Dietary
• ISSN: 2296-2565; 2296-2565
• DOI: 10.3389/fpubh.2022.1039770

Botulism outbreaks due to commercial products are extremely rare in the European Union. Here we report on the first international outbreak of foodborne botulism caused by commercial salt-cured, dried roach ( ). Between November and December 2016, an outbreak of six foodborne botulism type E cases from five unrelated households was documented in Germany and Spain. The outbreak involved persons of Russian and Kazakh backgrounds, all consumed unheated salt-cured, dried roach-a snack particularly favored in Easter-European countries. The implicated food batches had been distributed by an international wholesaler and were recalled from Europe-wide outlets of a supermarket chain and other independent retailers. Of interest, and very unlike to other foodborne disease outbreaks which usually involves a single strain or virus variant, different strains and toxin variants could be identified even from a single patient's sample. Foodborne botulism is a rare but potentially life-threatening disease and almost exclusively involves home-made or artisan products and thus, outbreaks are limited to individual or few cases. As a consequence, international outbreaks are the absolute exception and this is the first one within the European Union. Additional cases were likely prevented by a broad product recall, underscoring the importance of timely public health action. Challenges and difficulties on the diagnostic and epidemiological level encountered in the outbreak are highlighted.